How Are Pressure Sores Treated?
Pressure sores are a common problem for people who are bedridden or wheelchair-bound, as the lack of movement can cause these unsightly and often painful sores to form.
If you develop a pressure sore, it is important to seek clinical practice guideline treatment as soon as possible. There are many ways to treat pressure sores; treatment options include special dressings, using specialized cushions and mattresses, repositioning the patient regularly, medications, and surgery in some cases.
Receive a free case evaluation with our Illinois pressure sores attorneys if your loved one suffered severe injuries due to the negligence of nursing home staff. The personal injury attorneys at Rosenfeld Injury Lawyers, LLC, look forward to helping you recover financial compensation for your losses.
Pressure Sores Can Be Life-Threatening
Millions of people suffer from pressure ulcers, also known as bedsores or pressure sores. These injuries can range in severity from patches of discolored or dark skin to open wounds that expose the underlying bone or muscle.
Pressure ulcers are an injury that breaks down the skin’s surface and underlying tissue. They are caused when an area of skin is placed under pressure. For example, it can happen when a person is unable to change positions, such as bedridden or wheelchair-bound, or if they wear tight clothing that puts pressure on their skin.
The good news is that most pressure sores heal with treatment, but some never heal completely. That's why it's important to seek medical help if you think you might have a pressure ulcer. Treatment may include special dressings, antibiotics, and surgery in more severe cases.
Pressure ulcers, otherwise known as bed sores or pressure sores, are injuries to the skin and underlying tissue caused by unrelieved pressure. Pressure ulcers can be identified by forming a break of healthy skin, such as a red spot on an area of affected skin that becomes yellowish dead tissue and is covered with fluid.
Causes of Pressure Sores
Pressure sores usually form when a person cannot change position, like when immobile in bed or a wheelchair. It may be due to a medical condition, the use of certain drugs, limited mobility from an injury or illness, or being immobile for extended periods.
Pressure ulcers tend to develop gradually and may worsen over time if they are not treated, leading to infection and sepsis (blood poisoning). Pressure sores can occur anywhere on the body, but the lower back, buttocks, heels, ankles, hips, or shoulder blades are most at risk. In addition, people who have limited mobility and may be unable to move or adjust positions are also at risk of developing pressure ulcers. Contributing factors may include:
- Being bedridden, such as after an injury or surgery, recovery from a stroke, accident, or illness such as pneumonia
- Extended use of bed rest or sitting without movement in the same position
- Use of hard surfaces for prolonged periods, such as wheelchair seating surfaces
- Use of a traction device that holds a body part in a fixed position
- Impaired sensation, which makes it difficult to feel pressure on the vulnerable skin or discomfort from pressure
- Very soft or fragile skin
- Impaired physical mobility
- Mental impairment
Other risk factors include:
- Age 65 years or older
- Use of restraints, such as ropes, bars, straps, belts, or other devices used to limit movement in a bed or wheelchair for more than two hours at a time
- Medications, including anticoagulants (blood thinners) that affect blood flow to the skin
- History of pressure ulcers or other skin damage problems
- Poor Nutrition eating
- Reduced fluid intake
Symptoms of Pressure Ulcer
The most common symptom of a pressure sore is a break in the skin. Other symptoms can include:
- Discolored skin, such as sore redness or bruises
- Open wound exposing tissue and bone
- Blood-filled blister with a dark scab on top or draining pus (an accumulation of white blood cells that fight life-threatening infection)
- Burning sensation
- Sharp, stabbing pain
- A grating feeling as if something is moving across the skin (often due to shifting of dead tissue underneath the wound)
- Discomfort or aching that doesn't go away with rest and isn't relieved by over-the-counter pain medicine such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol)
Stages of Pressure Sore
Pressure ulcers are referred to as "Stage I" through "Stage IV," depending on their severity.
Stages I and II
At this stage, pressure ulcers appear as soft spots or shallow depressions in the skin. The surrounding tissue appears healthy. There is no broken skin. Often there is some redness to the affected area.
Stages III and IV
These are severe ulcers. The affected tissue (dead tissue) may be difficult or impossible to see beneath the surface of the ulcer because the injury goes down to the muscle/bone causing joint infections or supporting structures of the body.
The discoloration can be dark brown or black. Nerve endings are exposed and raw, causing pain. The area may look wet, with yellow or greenish fluid discharged from the wound. In Stage III, a pressure ulcer looks like a shallow crater.
The skin’s surface is no longer intact and may have some open areas with dried or scabbed material. There may be redness around this area, but not always. A fever is often present at this stage of a pressure ulcer.
With Stage IV pressure sores, the skin is completely broken. The dead tissue may appear charred or have a wet, weeping surface. Again, there may or may not be redness around the area of the pressure sore, and there is always a skin infection.
Fever is often present at this pressure ulcer stage and can lead to a blood poisoning infection.
Smoking and Pressure Ulcers
Smokers are at increased risk of developing pressure sores for many reasons, including poorer overall health, which prolongs healing time, increased blood supply problems in the lower body due to atherosclerosis, making it harder for blood vessels to carry oxygen throughout the body and increasing the risk of infection.
When Pressure Ulcers Are Severe
Pressure ulcers don't hurt all the time. That's because your nerve endings are dead at this point in the pressure sore development process--so it may feel better than you would expect.
When you press on the ulcer, you might feel pain, but it's usually not severe. The exception is an infection in or around the pressure sore that can cause severe pain and swelling of surrounding tissues.
Pressure Ulcers in Nursing Homes
According to the Centers for Disease Control and Prevention (CDC), pressure sores affect over 1.5 million Americans each year. It is important to act fast if you or someone you know has been injured because time is critical in these cases.
It's common for older people to develop pressure sores, and the risk of developing a pressure sore is even higher in people who:
- Live in institutions such as nursing homes
- Are bedridden or chair-bound for long periods
- Have altered sensation (from conditions such as diabetes or poor circulation)
- Have a limited ability to move around and shift positions (such as people with a spinal cord injury)
- Have a cognitive impairment
In addition to being at increased risk of developing pressure ulcers, institutionalized people are more likely to have infections in their bedsores because of:
- Frequent skin injury from the use of restraints or bedding that doesn't fit properly
- A prolonged stay same position decreases blood flow to the skin
- A compromised immune system is due to poor nutrition, blood sugar irregularities, vascular disease, or chronic disease.
If you or your loved one have suffered painful ulcers at the hands of nursing home staff, contact an experienced nursing home malpractice attorney at Rosenfeld Injury Lawyers. Call us today to receive a free consultation with our Illinois pressure sores attorneys.
We look forward to helping you recover what you deserve for your injuries. However, all cases are handled on a contingency basis - if we do not recover anything for you, we do not get paid.
We can assist you with nursing home neglect and abuse cases.
Factors that affect the likelihood of developing pressure sores among Nursing home patients
- The patient's age
- Longer hospitalizations
- Medical conditions of the patient
- Chronic illnesses like septic arthritis
- History of previous bed sores
- The type of care provided
- Having a deep tissue injury or wound
- The type of bed or mattress
- Whether the patient is continent (in control of their bladder and bowel functions)
People in nursing homes suffer more pressure sores than people living in the community because they're often confined to beds for long periods. Also, older adults in nursing homes are more likely to have conditions that delay wound healing, such as diabetes or poor blood circulation.
When pressure sores are left untreated, they can develop into more serious injuries. In addition, untreated sores may become infected, which can cause extensive tissue damage requiring surgery and possibly result in the patient's death.
What to Expect When Talking to a Nurse about Pressure Sores
The most important thing is to communicate how the patient feels. If the bedsores don't hurt, it's possible that they're not deep and will heal on their own with simple home care.
Treatment of pressure ulcers varies depending on some factors
- The age and health of the patient
- How deep the bedsore is
- The location of the wound
The treatment may include:
- Turning and repositioning the patient frequently
- Applying pressure-relieving devices to prevent further injury
- Turning regularly, using moist dressings can help keep skin clean around the sore by preventing it from drying out. (People with urinary catheters must have their skin cleaned and kept moist with a special type of dressing called a cath-tip.)
- Regularly changing the patient's position and daily bathing with mild soap can also help keep skin healthy and infection-free.
When to See a Doctor or Nurse About Bed Sores
Call your doctor or nurse for immediate medical care if you notice any of the following:
- Redness in skin around the sore
- Increased pain, especially when touched
- Skin that appears pale (whitish) or shiny; this appearance may indicate that infected tissue is dying, resulting in an infection; another sign is foul-smelling drainage from the sore
- A change in sensation around the affected area, such as numbness or a decrease in heat or cold sensitivity
- Increased swelling of tissues surrounding the wound
- If you notice any signs of infection, such as increased pain, redness at the edge of a wound, fever, warmth, swelling, and foul-smelling drainage
How Pressure Sores Are Treated: Preventing Pressure Ulcers
Treating pressure sores may vary, depending on the severity of the injury. Some common treatments include:
Daily Cleaning and Changing of Dressings
If a dressing is used to cover the wound, it must be checked regularly, and the wound kept clean with mild soap. Keep the skin clean and dry. Special dressings may be used on some pressure sores to keep them moist, which can help prevent further damage.
These special dressings are usually changed daily. It is also advised to use moist dressings for wound care to keep it moist with gentle saline, barrier creams, or water-based creams.
Removing Pressure From the Bony Areas of Your Body
Changing the position of your body regularly and using devices to relieve pressure (such as air mattresses, foam pads, or overstuffed pillows).
Medications to Help With Pain, Swelling, or Slow Healing
These may be prescribed if the pressure sore is causing a lot of pain.
Surgery may be needed for removing dead tissue and promoting healing for wounds that aren’t healing. For example, skin grafts are sometimes used to help treat infections or better wound closure. It may also be needed to remove dead tissue with surgical instruments if you have an infection or worsen your condition.
Medicine to Encourage Healing (Antibiotics)
Doctors might prescribe medication if an open sore is infected with bacteria. It is commonly done before surgical procedures.
Regular Intake of Essential Nutrients
Your doctor or nurse may advise you to increase your intake of vitamins, especially vitamin C. A suitable dietary plan is also important for proper healing of an open sore with or without body fat.
Insertion of Tubes (Catheters) in Areas Where the Skin is Dead to Remove Bodily Fluids (Debridement)
When skin is dead, the body's natural process of repairing lost tissue is slowed down. Doctors or nurses sometimes insert tubes (called catheters) under the skin to drain excess fluid and speed up the healing process and regeneration of new skin cells. The catheters are usually left in place until the sores heal.
How to Prevent Pressure Sores
The best way to prevent pressure ulcers is frequent repositioning. As much as possible, patients should be allowed to turn and move themselves to avoid life-threatening situations
- Applying pressure-relieving devices such as special mattresses and cushions (air, foam, or water)
- Performing daily skin and range of motion (ROM) to encourage a constant blood flow.
- Regularly doing a risk assessment of the skin.
Receiving regular massages and repositioning by nursing staff, care team, or family members. If you have a condition that makes it hard to change position, such as paralysis, your doctor may recommend special exercises to keep your muscles strong and supple. It can help prevent injury from lack of use (immobility).
- Regularly changing position and daily bathing will greatly protect pressure ulcers
- Drinking enough fluids to avoid dehydration and eating a healthy diet
Living With Pressure Sores
Living with pressure sores may be difficult. It requires constant care while the wound heals and, in some cases, once it has healed to keep scar tissue soft and pliable.
If you have a severe case of pressure sores or you cannot take care of yourself, your doctor may refer you to a special facility for surgical treatment. These facilities often offer treatment that helps restore your skin to its normal appearance.
Doctors might also refer you to an occupational or physical therapist, who can suggest exercises and treatments restore your range of motion (ROM).
Although pressure sores are painful and make daily life more difficult, the pain usually goes away after treatment begins. Many people who have sustained pressure sores recover completely, but it can take a long period (months) to heal. Sometimes, the skin may be permanently scarred or disfigured after treatment.
Hiring a Personal Injury Lawyer to Resolve Pressure Sores Claim
Have you or a loved one suffered from pressure sores and experienced serious scarring? If so, disfigurement, and long-term complications resulting from negligent care at a medical facility (such as an extended stay nursing home), it is important to hire an attorney who specializes in personal injury law and can speak with a pressure ulcer advisory panel on your behalf.
Our pressure sores injury lawyers at Rosenfeld Injury Lawyers have years of experience representing clients treated negligently in various medical settings, including nursing homes.
If you would like to know more about your legal rights and options under the law (or a referral to an appropriate medical specialist), please call (888) 424-5757 to schedule a free consultation with one of our experienced attorneys.